The National Institute for Health and Care Excellence (NICE) published new guidance entitled “Rehabilitation for chronic neurological disorders including acquired brain injury” (NG252) on 15 October 2025. In this article, Hannah
Ellis examines the guidance and what this means for anyone in England living with a long-term neurological condition.

The guidance sets out recommendations for all people (including children) living with a chronic neurological disorder, neurological impairment or disabling neurological symptoms due to acquired brain injury, acquired spinal cord injury, acquired peripheral nerve disorder, functional neurological disorder or progressive neurological disease.

The objective of the guidelines is to promote a person-centred, holistic and long-term approach to rehabilitation across all healthcare and social care settings. It is aimed at all health, mental health and social care practitioners who deliver care.

Rehabilitation

The World Health Organization (WHO) defines rehabilitation as “a set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment”.

The aim of rehabilitation is to help individuals live as independently as possible. Stewarts represents individuals whose lives have been irrevocably altered by catastrophic injury or illness. During the litigation process, we obtain funds from the defendant(s) to fund rehabilitation. Rehabilitation is a broad term that can involve a wide range of clinicians, including case managers, neuropsychologists, neurologists, occupational therapists and physiotherapists. We are well aware of the significance rehabilitation can have on our clients’ lives.

The guidelines

NICE recognises that many individuals are only offered rehabilitation when symptoms start to affect their functioning, and often, it is only provided in the short-term for specific symptoms. However, individuals with chronic neurological disorders can have lifelong or fluctuating needs. The guidelines identify that individuals require rehabilitation throughout their lives, not just immediately after their diagnosis or injury.

The NICE guidelines emphasise the importance of identifying the need for rehabilitation at an early stage to enable individuals to access interventions as soon as possible. Healthcare professionals should offer to discuss rehabilitation with them and their family and carers immediately after their injury or diagnosis. If the person is not willing to discuss rehabilitation plans, professionals should explore further options at a later date. The individual should also be provided with an initial contact for rehabilitation, and their GP should be informed.

One of the central recommendations in the guidelines is that everyone who needs neurorehabilitation should have access to a single point of contact, whether this is a key contact, key worker or complex case manager, to support and coordinate their rehabilitation needs and the services they require. The key contact or case manager should work closely with the individual to agree on their short and long-term goals and provide support throughout the process. They should remain in place even if the person is not receiving active rehabilitation.

Importantly, the guidelines encourage a collaborative, flexible approach to rehabilitation, tailored to the individual’s needs and characteristics. Historically, individuals have not felt confident to offer feedback about the services they have experienced. The guideline introduces the requirement for an active approach to seeking feedback, which will continue to improve rehabilitation services in the future and ensure that rehabilitation addresses the needs of each individual.

Other recommendations include the need to:

• provide information to individuals and their families and carers on their condition and how to access care
• advice on what financial support is available to assist with rehabilitation
• offer rehabilitation to maintain, improve or support function, eg pain management, fatigue, speech and language and mental wellbeing, and
• offer rehabilitation to support education, work, social and leisure activities, relationships and sex.

To find out more information, please visit NICE’s website: Overview | Rehabilitation for chronic neurological disorders including acquired brain injury | Guidance | NICE.

Conclusion

The NICE guidelines represent a positive step forward in improving rehabilitation and access to rehabilitation for people with chronic neurological disorders. The emphasis on having a single point of contact and the requirement for more coordinated care will be welcomed by people experiencing chronic neurological disorders or acquired brain injury who often have to navigate complex care provision.

The requirement on healthcare providers to offer intensive treatment focused on optimising recovery and emotional wellbeing is also welcome as it signals a commitment to holistic care and support, which is often missing for people going through these life-changing events.